"Medical tattooing is tattooing that is done for medical purposes as opposed to the picture type of tattoos … I do things like scar cover, but the most common one is that I tattoo the areolas and nipples on for women that have had mastectomies."

How many of these do you do?

"I do probably anywhere from two to five a month."

How did you get into doing the medical tattooing?

"It's a somewhat new thing. I had gone to school for permanent makeup. They have the medical tattooing as an add-on that you could take with that. When I did that, the class just blew me away…

"I, like pretty much everyone on the planet, know people that have breast cancer and have lost people to breast cancer ... I feel like every woman should feel beautiful. It doesn't matter what size we are, or what age we are, we all have the right to feel beautiful. I feel that women who have gone through breast cancer have gone through so much and that's kind of the lasting scar that's there forever. I know for me, that would drive me crazy."

What about other procedures you do?

"Scar covering or scar blending is another type of medical tattooing. The most recent one I did is a gentleman that had a very severe scar across his lip. So I tattooed his lip, where the scar is, to match the color of his lip. You can do that to pretty much anywhere on the body where there's a discoloration.

"Another example would be someone that had cleft lip, cleft palate. After all their surgeries, they may look pretty good but they might have a little difference on one side with the lip shape. And I can just restructure the shape of the lip.

"After hair transplants, that's another I can do to cover up the hair transplant scar. I just tattoo on little tiny hairs. Alopecia, too."

How do you get the right coloring for a person?

"I rarely use just one (color) just straight out of the bottle. I mix them and match them to create the color that the person wants. You also have to know color theory. That's part of what you learn in school. You then put samples on their skin and let it sit … and redo it until you get the color the people want."

Could you take us through the procedure of tattooing on a nipple?

"You start out with paperwork; tons and tons of paperwork: consent forms, medical histories, all that kinds of stuff.

"Then we come in the room and sit down and talk. I absolutely make sure that everyone understands everything that we're doing and that I answer any questions that they have.

"Then I go ahead and set everything up. Everything is sterile, single use… Nothing is ever possibly transferred from one person to another.

"Then we go through color choices and we also go through marking.

"For the areola and nipple, I would actually use a circle guide and hold that up to the breast and talk to the client about what size was appropriate for them.

"When I draw, I make that circle — it looks kind of like a target. One of the errors that people who do this sometimes make is they'll draw that circle on and tattoo that circle. Then it ends up looking like a pasty or a target. You actually want to start in the middle. That's only an eye guide, and you fan it out using a row of flat needles so it creates a soft, edgy uneven look.

"A topical anesthesia is used before I start tattooing. There's a different anesthesia that after you've gone over it one time, you put that on. It only works when the skin is broken."

How long does the procedure take?

"For both (breasts), the client has to plan for about five hours. It actually takes two sessions as well. ... They come back about 30 days later and that gives us a chance to re-evaluate the color choice … and also it fills in if there were any missed spots or blotches anywhere and it allows me to get a stronger highlight and to create that nipple with a 3-D tattooing effect, if they didn't have that in reconstructive surgery."

3-D tattooing?

"It works by using color, just the same as painting. You would use different highlights of color to create depth."

What sort of feedback do you get from clients?

"Some cry, some laugh. I had one woman that got up and looked in that mirror right there and she said, 'That's the first time I've looked in the mirror in four years.'

"It really, really affects someone's life. Every time, I get tears because it affects me that I'm able to make this change in someone's life.

"People forget that men get (breast) cancer, too ... This can be done on men and women."

What does it cost?

"The normal charge is $200 for one (breast), $400 for both. If someone does have medical insurance they can do it through a plastic surgeon's office. I actually have been talking to some plastic surgeons about doing some in their office for people that have medical insurance. But many people don't, or some people with co-pays don't feel it's worth it. What plastic surgeons bill insurance is like $3,800 to $4,000. The co-pay could actually be more than them self-paying."